Patients' Preferences for Treatment for Dupuytren's Disease: A Discrete Choice Experiment.

BACKGROUND: Although in modern medicine, patients' preferences are important, these have never been defined for characteristics of Dupuytren treatment. This study determines these patients' preferences using a discrete choice experiment.

METHODS: A multicenter discrete choice experiment study was conducted among patients with Dupuytren's disease who had been treated previously. Patients were asked about their preferences for attributes of Dupuytren treatments using scenarios based on treatment method, major and minor complication rates, recurrence rates, convalescence, residual extension deficit after treatment, and aesthetic results. The relative importance of these attributes and the tradeoffs patients were willing to make between them were analyzed using a panel latent class logit model.

RESULTS: Five-hundred six patients completed the questionnaire. All above-mentioned attributes proved to influence patients' preferences for Dupuytren treatment (p < 0.05). Preference heterogeneity was substantial. Men who stated they performed heavy labor made different tradeoffs than women or men who did not perform heavy labor. In general, recurrence rate (36 percent) and extension deficit (28 percent) were the most important attributes in making treatment choices, followed by minor complication rate (13 percent). Patients accepted an increase in recurrent disease of 11 percent if they could receive needle aponeurotomy treatment instead of limited fasciectomy.

CONCLUSIONS: This study confirms the importance of low recurrence rates and complete contracture corrections, but also emphasizes the significance of low complication rates. Convalescence was not an attribute, which scored high. The preference heterogeneity shows that patient consultations need to be targeted differently, which may result in different treatment decisions, depending on patient characteristics and preferences.